Provider First Line Business Practice Location Address:
STONY BROOK FAMILY AND PREVENTIVE MEDICINE, UFPC
Provider Second Line Business Practice Location Address:
4 SMITH HAVEN MALL, SUITE 202
Provider Business Practice Location Address City Name:
LAKE GROVE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-5858
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2019